Signet ring colorectal carcinoma: Do we need to improve the treatment algorithm?

Table 1 Demographic parameters

Parameter	Statistics
Total No.	170
Sex ratio
Male	110
Female	60
Age (median), yr	41
Stage, n (%)
II	6 (3.5)
III	88 (51.8)
IV	67 (39.4)
Not available	9 (5.3)
Location, n (%)
Right colon	49 (28.8)
Transverse colon	13 (7.6)
Descending colon	11 (6.5)
Sigmoid colon	23 (13.5)
Rectum	70 (41.2)
Appendix	1 (0.6)
Not available	3 (1.8)

Table 2 Pattern of metastases in stage IV patients

Site of metastases	n (%)
Liver	1 (1.5)
Lung	1 (1.5)
Isolated peritoneal	58 (86.5)
Retroperitoneal lymphnodes	2 (3.1)
Others	5 (7.4)

Table 3 Pattern of recurrence after curative surgery

Pattern of recurrence	n (%)
Locoregional	4 (12.12)
Distant	4 (12.12)
Isolated peritoneal	21 (63.63)
Peritoneal + second primary	2 (6.06)
Local + peritoneal	2 (3.4)

Regional recurrences: Regional lymph node recurrences; Distant recurrences: Non-regional lymph nodal and visceral recurrences.

Table 4 Factors affecting overall survival

Parameter	OS (mo)	Significance
Location (After curative surgery)
Colon	32.3	0.058
Rectum	40.1
CRM
Positive	19.9	0.018
Negative	41.5
Metastases
Peritoneal	14.85	0.729
Non-peritoneal	11.14

CRM: Circumferential resection margin; OS: Overall survival.

Table 5 Factors affecting relapse free survival in operated patients

Parameter	RFS (mo)	Significance
CRM
Positive	15.003	0.060
Negative	37.202
Location
Colon	24.74	0.048
Rectum	34.02

RFS: Relapse free survival; CRM: Circumferential resection margin.

Table 6 Impact of location on outcome

Parameter	Colon	Rectum	Significance
Recurrence after curative resection
Peritoneal, n (%)	15/40 (37.5)	8/48 (16.7)	0.062
Non-peritoneal, n (%)	3/40 (7.5)	7/48 (14.6)
Pattern of Metastases at presentation
Peritoneal, n (%)	45/49 (91.8)	15/18 (83.3)	0.074
Non-peritoneal, n (%)	4/49 (9.2)	3/18 (16.7)
RFS (mo)	24.74	34.02	0.048
Overall Survival (mo)	26.011	30.32	0.062
OS after curative surgery (mo)	32.298	40.089	0.058

RFS: Relapse free survival; OS: Overall survival.